Pharmacotherapy for obstructive sleep apnea: targeting specific pathophysiological traits.

IF 2.9 3区 医学 Q2 RESPIRATORY SYSTEM Expert Review of Respiratory Medicine Pub Date : 2023-07-01 Epub Date: 2023-08-30 DOI:10.1080/17476348.2023.2241353
Elisa Perger, Simona Bertoli, Carolina Lombardi
{"title":"Pharmacotherapy for obstructive sleep apnea: targeting specific pathophysiological traits.","authors":"Elisa Perger,&nbsp;Simona Bertoli,&nbsp;Carolina Lombardi","doi":"10.1080/17476348.2023.2241353","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>The pathophysiology of obstructive sleep apnea (OSA) is multi-factorial and complex. Varying OSA's pathophysiological traits have been identified, including pharyngeal collapsibility, upper airway muscle reactivity, arousal threshold, and regulation of the ventilatory drive. Being CPAP of difficult tolerance and other interventions reserved to specific subpopulations new pharmacological treatments for OSA might be resolutive.</p><p><strong>Areas covered: </strong>Several existing and newly developed pharmacological drugs can impact one or more endotypes and could therefore be proposed as treatment options for sleep disordered breathing. With this review we will explore different pathophysiological traits as new targets for OSA therapy. This review will summarize the most promising pharmacological treatment for OSA accordingly with their mechanisms of action on upper airway collapsibility, muscle responsiveness, arousal threshold, and loop gain.</p><p><strong>Expert opinion: </strong>Only understanding the pathophysiological traits causing OSA in each patient and placing the disease in the framework of patient comorbidities, we will be able to evolve interventions toward OSA. The development of new drug's combinations will permit different approaches and different choices beside conventional treatments. In the next future, we hope that sleep specialists will select the treatment for a specific patient on the base of its pathophysiology, defining a precision medicine for OSA.</p>","PeriodicalId":12103,"journal":{"name":"Expert Review of Respiratory Medicine","volume":null,"pages":null},"PeriodicalIF":2.9000,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Expert Review of Respiratory Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/17476348.2023.2241353","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/8/30 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"RESPIRATORY SYSTEM","Score":null,"Total":0}
引用次数: 0

Abstract

Introduction: The pathophysiology of obstructive sleep apnea (OSA) is multi-factorial and complex. Varying OSA's pathophysiological traits have been identified, including pharyngeal collapsibility, upper airway muscle reactivity, arousal threshold, and regulation of the ventilatory drive. Being CPAP of difficult tolerance and other interventions reserved to specific subpopulations new pharmacological treatments for OSA might be resolutive.

Areas covered: Several existing and newly developed pharmacological drugs can impact one or more endotypes and could therefore be proposed as treatment options for sleep disordered breathing. With this review we will explore different pathophysiological traits as new targets for OSA therapy. This review will summarize the most promising pharmacological treatment for OSA accordingly with their mechanisms of action on upper airway collapsibility, muscle responsiveness, arousal threshold, and loop gain.

Expert opinion: Only understanding the pathophysiological traits causing OSA in each patient and placing the disease in the framework of patient comorbidities, we will be able to evolve interventions toward OSA. The development of new drug's combinations will permit different approaches and different choices beside conventional treatments. In the next future, we hope that sleep specialists will select the treatment for a specific patient on the base of its pathophysiology, defining a precision medicine for OSA.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
阻塞性睡眠呼吸暂停的药物治疗:针对特定的病理生理特征。
引言:阻塞性睡眠呼吸暂停(OSA)的病理生理学是多因素和复杂的。OSA的各种病理生理特征已经被确定,包括咽部塌陷、上呼吸道肌肉反应性、唤醒阈值和通气驱动的调节。作为难耐受的CPAP和保留给特定亚群的其他干预措施,OSA的新药物治疗可能是可行的。涵盖的领域:几种现有和新开发的药理学药物可以影响一种或多种内型,因此可以作为睡眠呼吸障碍的治疗选择。通过这篇综述,我们将探索不同的病理生理特征作为OSA治疗的新靶点。这篇综述将相应地总结OSA最有前景的药物治疗方法,以及它们对上呼吸道塌陷性、肌肉反应性、唤醒阈值和环路增益的作用机制。专家意见:只有了解每个患者引起OSA的病理生理特征,并将该疾病置于患者合并症的框架中,我们才能发展针对OSA的干预措施。新药组合的开发将允许在传统治疗之外采用不同的方法和选择。在未来,我们希望睡眠专家能够根据特定患者的病理生理学来选择治疗方法,从而为OSA定义一种精确的药物。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
CiteScore
6.80
自引率
2.60%
发文量
90
期刊介绍: Coverage will include the following key areas: - Prospects for new and emerging therapeutics - Epidemiology of disease - Preventive strategies - All aspects of COPD, from patient self-management to systemic effects of the disease and comorbidities - Improved diagnostic methods, including imaging techniques, biomarkers and physiological tests. - Advances in the treatment of respiratory infections and drug resistance issues - Occupational and environmental factors - Progress in smoking intervention and cessation methods - Disease and treatment issues for defined populations, such as children and the elderly - Respiratory intensive and critical care - Updates on the status and advances of specific disease areas, including asthma, HIV/AIDS-related disease, cystic fibrosis, COPD and sleep-disordered breathing morbidity
期刊最新文献
Non-invasive respiratory support in elderly hospitalized patients. Overcoming challenges of managing chronic obstructive pulmonary disease in low- and middle-income countries Understanding the impact of breathing pattern disorders in difficult-to-treat asthma Omics research in lymphangioleiomyomatosis: status and challenges. A clinician's guide to effects of obesity on childhood asthma and into adulthood.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1